REENA JIJU KAVILAVEETTIL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

CANCELLED

Business

First Name

REENA

Middle

JIJU

Last Name

KAVILAVEETTIL

Suffix

Business Name

REENA JIJU KAVILAVEETTIL MD

Original Issue Date

06/03/2004

Effective Date

06/03/2004

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008